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South Africa

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South Africa faces interrelated burdens of disease resulting from a mixture of communicable diseases such as HIV/AIDS and tuberculosis as well as non-communicable diseases including type 2 diabetes, obesity, hypertension, cardiovascular diseases and cancers. Prevalence rates of obesity and type 2 diabetes are especially high among women. In 2010, approximately 9% of men and 12% of women in South Africa had diabetes, a nearly twofold increase since 1980. Approximately 90% of this group suffers from type 2 diabetes, of which 60% is estimated to be unscreened and undiagnosed.

Policy Research

Policies

Rates and Monetary Amounts and Amendment of Revenue Laws Act 2017, Act No. 14 | Implemented April 1, 2018

Health Promotion Levy

For all non-alcoholic beverages and beverage concentrates, manufacturers & distributors taxed:

  • R0.021 ($0.0014 USD) per gram sugar in excess of 4 g/100 mL.
  • If sugar is not labeled, product taxed at default rate based on containing 20 g sugar/100mL (R0.336/100 mL or $0.023 USD).

Exempt: 100% juice, dairy beverages

Developing

Front-of-package warning labels

After conducting focus groups to test and determine the most effect shape, color, and style for the proposed warning labels, researchers in South Africa conducted a randomized controlled trial to test the warning label alongside a traffic light label and Guideline Daily Amounts label. This experiment was led by Rina Swart as part of a Department of Health task force. UWC compiled an extensive technical report that summarized all of their research on nutrient profiling models and front-of-package labels, which they presented to the National Department of Health with their evidence-based policy recommendations.

The Department of Health released a draft front-of-package warning label regulation in April 2023, which was originally open for public comment through July 2023. This deadline was extended to September 21, 2023.

In-Country Research Partners

In-Country Team Leads

GFRP Team Leads

Publications

  • Dietary intake of low-income adults in South Africa: Ultra-processed food consumption a cause for concern.
    Authors: Tamryn Frank, Shu Wen Ng, Caitlin Lowery, Anne-Marie Thow, Elizabeth Swart.
    Published in: Public Health Nutrition. January 11, 2024 view full text

  • Child-directed marketing on packaged breakfast cereals in South Africa
    Authors: Alice Kahn, Tamryn Frank, Rina Swart
    Published in: Public Health Nutrition, August 4, 2023 view full text

  • Beverage industry’s advertising expenditures and airtimes in South Africa from 2013 to 2019 target children and families
    Authors: Micheal Kofi Boachie, Susan Goldstein, Petronell Kruger, Shu Wen Ng, Karen J. Hofman, Evelyn Thsehla
    Published in: Journal of Public Health Research, April 24, 2023 view full text

  • Are intentions to change, policy awareness, or health knowledge related to changes in dietary intake following a sugar-sweetened beverage tax in South Africa? A before-and-after study
    Authors: Michael Essman, Catherine Zimmer, Francesca Dillman Carpentier, Elizabeth C. Swart, Lindsey Smith Taillie
    Published in: International Journal of Behavioral Nutrition and Physical Activity, October 28, 2022 view full text

  • Effect of different front-of-package food labels on identification of unhealthy products and intention to purchase the products – A randomised controlled trial in South Africa
    Authors: Makoma Bopape, Jeroen De Man, Lindsey Smith Taillie, Shu Wen Ng, Nandita Murukutla, Rina Swart
    Published in: Appetite, August 24, 2022 (online ahead of print) view full text

  • Perceived effect of warning label on parental food purchasing and drivers of food selection among South African parents — An exploratory study
    Authors: Makoma Bopape, Lindsey Smith Taillie, Rina Swart
    Published in: Frontiers in Public Health, August 5, 2022 view full text

  • Decomposing consumer and producer effects on sugar from beverage purchases after a sugar-based tax on beverages in South Africa
    Authors: Maxime Bercholz, Shu Wen Ng, Nicholas Stacey, Elizabeth C. Swart
    Published in: Economics & Human Biology, March 21, 2022 view full text

  • South Africa’s Health Promotion Levy on pricing and acquisition of beverages in local spazas and supermarkets
    Authors: Alexandra Ross, Elizabeth C. Swart, Tamryn Frank, Caitlin M. Lowery, Shu Wen Ng
    Published in: Public Health Nutrition, March 7, 2022 view full text

  • Applying and comparing various nutrient profiling models against the packaged food supply in South Africa
    Authors: Tamryn Frank, Shu Wen Ng, Donna R. Miles, Elizabeth C. Swart
    Published in: Public Health Nutrition, February 16, 2022 view full text

  • Examining the news media reaction to a national sugary beverage tax in South Africa: A quantitative content analysis
    Authors: Michael Essman, Fernanda Mediano Stoltze, Francesca Dillman Carpentier, Elizabeth C. Swart, Lindsey Smith Taillie
    Published in: BMC Public Health, December 2021 view full text

  • South African consumers' perceptions of front-of-package warning labels on unhealthy foods and drinks
    Authors: Makoma Bopape, Lindsey Smith Taillie, Tamryn Frank, Nandita Murukutla, Trish Cotter, Luyanda Majija, Rina Swart
    Published in: PLOS ONE, September 27, 2021 view full text

  • A fit-for-purpose nutrient profiling model to underpin food and nutrition policies in South Africa
    Authors: Tamryn Frank, Anne-Marie Thow, Shu Wen Ng, Jessica Ostrowski, Makoma Bopape, Elizabeth C. Swart
    Published in: Nutrients, July 28, 2021 view full text

  • South Africa's health promotion levy: Excise tax findings and equity potential
    Authors: Karen Hofman, Nicholas Stacey, Elizabeth Swart, Barry Popkin, Shu Wen Ng
    Published in: Obesity Reviews, May 31, 2021 view full text

  • Taxed and untaxed beverage consumption by young adults in Langa, South Africa before and one year after a national sugar-sweetened beverage tax
    Authors: Michael Essman, Lindsey Smith Taillie, Tamryn Frank, Shu Wen Ng, Barry M. Popkin, Elizabeth C. Swart
    Published in: PLOS Medicine, May 25, 2021 view full text

  • Changes in beverage purchases following the announcement and implementation of South Africa's Health Promotion Levy: An observational study
    Authors: Nicholas Stacey, Ijeoma Edoka, Karen Hofman, Elizabeth C. Swart, Barry Popkin, and Shu Wen Ng
    Published in: The Lancet Planetary Health, April 1, 2021 view full text